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1831799238
JERRY GEORGE GREESON
JBSA LACKLAND, TX
NPI
1831799238
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207PS0010X Emergency Medicine, Sports Medicine
(Licence: TX AT0646)
Enumeration Date
2020-10-27
Last Update Date
2020-10-27
Business Address
JERRY GEORGE GREESON Med, LAT, ATC
2239 WALKER AVE BLDG 5570
JBSA LACKLAND, TX 78236-5632
Phone number: 210-365-8316
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Mailing Address
JERRY GEORGE GREESON Med, LAT, ATC
24526 DREW GAP
SAN ANTONIO, TX 78255-2284
Phone number: 210-365-8316
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